Content contributed by Nira Rittenberg, Occupational Therapist from the Baycrest Health Sciences in Toronto, Ontario; this article was originally published in the Toronto Star.
Mom just had another fall at home. She is badly bruised, and I am freaked! This is her third fall this month.
A lot of seniors like to say that their fall “just happened.” That is not the case, according to the Public Health Agency of Canada. Falls are the main cause of hospital admissions for older adults. About 20 per cent to 30 per cent of Canadian seniors experience a fall yearly. The impact is felt not only by the injured senior, but by their family, friends and the entire health-care system. The truth is, many of these falls are fully preventable.
Research has shown that people fall for a variety of reasons such as, muscle weakness in the legs and changes in gait patterns as people age, which can be due to lack of exercise, arthritis or neurological causes. Changes in blood pressure, especially when standing up, dehydration and certain medications can also increase one’s risk of falling. Inappropriate footwear is a huge culprit too — especially backless shoes, smooth-bottomed shoes or heels. Sensory problems with one’s vision — cataracts and glaucoma to name just two — can lead to poor depth perception or difficulty adjusting to light changes. Poor sensation in the feet can result in not knowing what you are stepping onto or into.
Certain medications can increase your risk of falls and cause dizziness and unsteadiness. Talk to your physician. Don’t make changes alone! Poor reflexes may mean that if you start to fall you may not have the ability to recover and catch yourself.
Confusion can also result in a fall, as you may be unsure of your physical surroundings. Those with dementia or other cognitive issues are 2-3 times more likely to sustain a fall.
Those with a history of falls are also more likely to incur another fall. This can happen as a result of health issues, but also by ignoring recommended suggestions about avoiding falls.
You are wise to worry about mom having multiple falls. After a proper medical assessment to ensure that there is no immediate health cause for her falls (a new illness, etc.) a proper and thorough assessment of her and her environment is warranted. I tell many of my clients that it is hard to look at your own home objectively and understand the issues at play. Therapists are trained to do this and to assess relative risk. Since we know most falls happen at home, an inspection there is a good start.
Some practical changes to consider are: Removing items that can cause trips and falls, like small furniture, cords and rugs. Creating room in pathways and avoiding clutter on stairs is also key.
Throw rugs are a common culprit. Although you may “know they are there,” these rugs are often easy to trip or slip on. If they can be removed, they should be. If not, use double- sided tape to hold the edges down to the floor and ensure they don’t slip underfoot.
Poor lighting is often a problem too, especially in transition areas like entrances and stairs. High wattage bulbs are recommended. Placing non-slip strips on stairs and floors can also help.
Bathrooms are also a potentially huge hazard, as surfaces like tiles and marble are unforgiving. Properly placed grab bars in your tub and shower, and next to the toilet, can make a world of difference in maintaining stability.
Rearranging commonly used items for access and ensuring you have handrails on both sides of staircases also makes things safer. With winter closing in, have a plan for salting your walkway and/or driveway and be sure to wear footwear with good traction.
A bedside lamp and night light is optimal for safe, nighttime bathroom trips. Many falls occur while someone is in a drowsy state.
Devices such as canes, walkers and reachers, properly prescribed by a physiotherapist or occupational therapist, can help. Keeping a portable phone in reach or subscribing to an emergency alert system may be ideal.
A good falls prevention program that includes gait and general exercises can help a lot. Educating someone about how to properly manage if they do fall can also prevent further injury.
So don’t fall apart — just take the right steps to prevent a fall!
Nira Rittenberg is an occupational therapist who specializes in geriatrics and dementia care at Baycrest Health Sciences Centre and in private practice. She is co-author of Dementia A Caregiver’s Guide available at www.baycrest.org/dacg. Email questions to firstname.lastname@example.org.